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Deininger MW, Shah NP, Altman JK, Berman E, Bhatia R, Bhatnagar B, DeAngelo DJ, Gotlib J, Hobbs G, Maness L, Mead M, Metheny L, Mohan S, Moore JO, Naqvi K, Oehler V, Pallera AM, Patnaik M, Pratz K, Pusic I, Rose MG, Smith BD, Snyder DS, Sweet KL, Talpaz M, Thompson J, Yang DT, Gregory KM, Sundar H. Chronic Myeloid Leukemia, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2020; 18:1385-1415. [PMID: 33022644 DOI: 10.6004/jnccn.2020.0047] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chronic myeloid leukemia (CML) is defined by the presence of Philadelphia chromosome (Ph) which results from a reciprocal translocation between chromosomes 9 and 22 [t(9;22] that gives rise to a BCR-ABL1 fusion gene. CML occurs in 3 different phases (chronic, accelerated, and blast phase) and is usually diagnosed in the chronic phase. Tyrosine kinase inhibitor therapy is a highly effective first-line treatment option for all patients with newly diagnosed chronic phase CML. This manuscript discusses the recommendations outlined in the NCCN Guidelines for the diagnosis and management of patients with chronic phase CML.
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Affiliation(s)
| | - Neil P Shah
- UCSF Helen Diller Family Comprehensive Cancer Center
| | - Jessica K Altman
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | - Bhavana Bhatnagar
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | | | | | | | - Leland Metheny
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | | | - Kiran Naqvi
- The University of Texas MD Anderson Cancer Center
| | - Vivian Oehler
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | - Arnel M Pallera
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | - Keith Pratz
- Abramson Cancer Center at the University of Pennsylvania
| | - Iskra Pusic
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | - B Douglas Smith
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | - David T Yang
- University of Wisconsin Carbone Cancer Center; and
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Cesini L, Frieri C, Baratè C, Sorà F, Bonifacio M, Cerrano M, Cagnetta A, Elena C, Aprile L, Sgherza N, Trawinska M, Gozzini A, Capodanno I, Crugnola M, Carmosino I, Scalzulli E, Ricci F, Bocchia M, Bergamaschi M, Aguzzi C, Sica S, Galimberti S, Breccia M, Luciano L, Latagliata R. Erythropoietin treatment in chronic phase chronic myeloid leukemia patients treated with frontline imatinib who developed late anemia. Eur J Haematol 2020; 105:286-291. [PMID: 32365249 DOI: 10.1111/ejh.13436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Role of erythropoietin (EPO) in the treatment of late anemia in patients with Chronic Myeloid Leukemia (CML) is still undefined. METHODS Fifty CML patients treated at 14 institutions with frontline imatinib for at least 12 months and in stable complete cytogenetic response who developed a late chronic anemia treated with EPO were retrospectively evaluated. RESULTS Median time from imatinib start to EPO treatment was 42.2 months [interquartile range (IQR) 20.8-91.9]. Median Hb value at EPO starting time was 9.9 g/dL (IQR 8.9-10.3): Eleven patients (22.0%) were transfusion dependent. Alpha-EPO (40 000 UI weekly) was employed in 37 patients, beta-EPO (30 000 UI weekly) in 9 patients, zeta-EPO (40 000 UI weekly) in 2 patients, and darbepoetin (150 mcg/weekly) in the remaining 2 patients. On the whole, 41 patients (82.0%) achieved an erythroid response, defined as a stable (>3 months) improvement >1.5 g/dL of Hb level, and 9 patients (18.0%) indeed resulted resistant. Among responding patients, 10 relapsed after a median time from EPO start of 20.7 months (IQR 10.8-63.7). No EPO-related toxicity was observed. CONCLUSIONS Results of EPO treatment for late chronic anemia during long-lasting imatinib therapy are encouraging, with a high rate of response.
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Affiliation(s)
- Laura Cesini
- Department of Translational and Precision Medicine, University "La Sapienza" of Rome, Rome, Italy
| | - Camilla Frieri
- Hematology, University "Federico II" of Neaples, Naples, Italy
| | - Claudia Baratè
- Department of Clinical and Experimental Medicine - Hematology, University of Pisa, Pisa, Italy
| | - Federica Sorà
- Hematology, Catholic University of Sacred Heart of Rome, Rome, Italy
| | | | - Marco Cerrano
- Department of Oncology and Hematology, University of Turin, Turin, Italy
| | | | | | - Lara Aprile
- Division of Hematology, University of Siena, Siena, Italy
| | - Nicola Sgherza
- Hematology, IRCCS, "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | | | | | | | | | - Ida Carmosino
- Department of Translational and Precision Medicine, University "La Sapienza" of Rome, Rome, Italy
| | - Emilia Scalzulli
- Department of Translational and Precision Medicine, University "La Sapienza" of Rome, Rome, Italy
| | - Federica Ricci
- Department of Clinical and Experimental Medicine - Hematology, University of Pisa, Pisa, Italy
| | - Monica Bocchia
- Division of Hematology, University of Siena, Siena, Italy
| | | | - Chiara Aguzzi
- Department of Oncology and Hematology, University of Turin, Turin, Italy
| | - Simona Sica
- Hematology, Catholic University of Sacred Heart of Rome, Rome, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine - Hematology, University of Pisa, Pisa, Italy
| | - Massimo Breccia
- Department of Translational and Precision Medicine, University "La Sapienza" of Rome, Rome, Italy
| | | | - Roberto Latagliata
- Department of Translational and Precision Medicine, University "La Sapienza" of Rome, Rome, Italy
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Wang Z, Mi YC. [The significance of non-Ph chromosome in chronic myelogenous leukemia]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 41:701-704. [PMID: 32942830 PMCID: PMC7525163 DOI: 10.3760/cma.j.issn.0253-2727.2020.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Z Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y C Mi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
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